近五年来中医体质类型与骨质疏松症相关性研究的现状

Research status of correlation between TCM constitution and osteoporosis in recent five years

目的探析近五年来中医体质类型与骨质疏松症(OP)的相关性研究的现状,探讨OP患者的中医体质分布规律,更好地为中医药防治OP提供一定的基础数据。方法对2013年1月～2017年12月在国内外期刊发表的有关OP与中医体质相关性的调查文献,以"骨质疏松、中医体质"为检索词进行检索,并将最终纳入的文献根据类型分为病例对照研究和横断面研究,分别进行综合分析。结果共检索105篇全文文献,其中11篇文献符合要求,调查范围涉及全国9个省市自治区,单个调查样本量80～1 957例,研究类型中横断面研究为6篇(54.55%),病例对照研究为5篇(45.45%)。提取两种研究中OP患者在样本中所占人数,发现在横断面研究中气虚型体质OP患者占6项总样本量3 251人的9.07%,阳虚型体质为7.90%,阴虚型体质为9.25%,同时基于1 992人的大样本人群病例对照研究的Meta分析发现,OP患者为气虚型体质、阳虚型体质、阴虚型体质的发病风险的OR值分别为1.29(95%CI:1.00～1.65),1.90(95%CI:1.44～2.49)和1.95(95%CI:1.47～2.59)。并发现华北地区、华东地区OP患者多以气虚型体质与阴虚型体质为主,而中南地区、西北地区OP患者多以气虚型体质与阳虚体质为主。结论气虚型体质、阳虚型体质、阴虚型体质以及血瘀型体质是OP患者的主要体质类型,通过大样本量的分析,期望为未来中医药防治OP,提供一定的参考价值,但目前的文献仍然缺乏多种相关因素的研究,这可能会对判断OP患者的中医体质出现偏颇,有待进一步提高。

Objective To explore the correlation between TCM constitution type and osteoporosis(OP)in the past five years,the distribution of TCM constitution in patients with OP,and to provide basic data for the prevention and control of OP.Methods The literatures on the correlation between OP and TCM constitution published in the national and international journals from January 2013 to December 2017 were searched using the term osteoporosis and TCM constitution as the search term.The final included literatures were divided into case-control studies and cross-sectional studies according to their types.A comprehensive analysis was conducted.Results A total of 105 full-text articles were retrieved,of which 11 articles met the requirements.The survey covered 9 provinces across the country,with a single survey sample size of 80 to 1957 cases.There were 6 cross-sectional studies(54.55%)and 5 control studies(45.45%).The number of patients with OP in the two studies was sampled.It was found that in the cross-sectional study,the patients with deficiency of qi constitution accounted for 9.07%in 3251 cases of the 6 studies,the yang deficiency type accounted for 7.90%,and yin deficiency type accounted for 9.25%.The meta-analysis based on a case-control study of 1992 cases found that the odds ratios of OP patients with qi deficiency,yang deficiency,and yin deficiency were 1.29(95%CI:1.00-1.65),1.90(95%CI:1.44-2.49),and 1.95(95%CI:1.47-2.59),respectively.It was also found that patients with OP in north and east China mostly had qi deficiency type and yin deficiency type,while those in middle south and northwest China had qi deficiency type and yang deficiency type.Conclusion Qi deficiency,yang deficiency,yin deficiency,and blood stasis type constitution are the main constitution types of OP patients.Through the analysis of large sample size,it is expected to provide a certain reference value for prevention and treatment of OP in the future.The current literature still lacks research on a variety of relevant factors,which may bias the judgment of the TCM physique of OP patients and need further improvement.